Painkiller epidemic

America is reeling from the opioid crisis. Painkillers are causing the deaths of far more people than terrorism or mass shootings.

Today, an epidemic fueled in part by perfectly legal substances is taking out Americans in all walks of life.

The executive director of the Association of American Physicians and Surgeons, Dr. Jane Orient, puts it succinctly: “The crisis is real, it is lethal, and it may be killing the nice family that lives next door to you.”

It’s easy to relegate the scourge to the back of your mind, until a friend, a friend’s child or a relative dies of an accidental drug overdose. Those are happening in greater frequency.

President Donald Trump recently characterized the situation as a public health emergency.

Opioids range from legal prescription drugs such as Vicodin, Percocet and OxyContin, to illegal narcotics such as heroin and opium. Now there are synthetic opioids like methadone, fentanyl and more recently carfentanil, which is 10,000 times more potent that morphine.

In Texas, Bexar County has the grim distinction of the highest rate of infant opioid withdrawal, and the third highest overdose death rate. These are finally being addressed.

In August, a new Opioid Task Force, co-chaired by city Metropolitan Health District Director Colleen Bridger and University Health System Executive Vice President and Chief Medical Officer Dr. Bryan Alsip, met for the first time.

The group’s primary goals are fivefold, Bridger told me.

The first is purely practical — getting the anti-overdose drug naloxone, or Narcan, into more hands. You don’t need a prescription to buy the drug in Texas. San Antonio Fire Department and emergency medical services have carried it for several years. Placing it with police comes next, Bridger said.

Second, the task force aims to train more providers — including physicians, dentists and pharmacists — to avoid overprescribing.

“We know a lot of heroin users got addicted to opioids through legitimate use of prescribed drugs,” she said.

The third objective is more widespread use of the Texas Prescription Monitoring Program, which can help providers see what drugs have already been administered to patients and whether prescriptions have been filled, as well as identify overprescribers.

The next goal, increasing access to treatment, is a toughie.

“That’s definitely a problem,” Bridger said. “There are some beds available, but for anything affordable there is a minimum 30-day wait.”

In October, the Bexar County Commissioners Court authorized two San Antonio law firms to file suit against about a dozen drugmakers and distributors, claiming they misled medical providers and patients about the safety of pain drugs. Kudos to Commissioner Kevin Wolff, whose amendment stipulated that any money from the lawsuit go toward more drug-abuse treatment and research.

The committee’s final mission, key to changing things, is public education – increasing awareness of the problem itself, or the terrible consequences, which can result from something as innocent as leaving an unfinished prescription bottle within reach.

When folks truly understand the rampant devastation opioids are unleashing, and when more treatments — both for emergency overdose and for addiction – are readily available, death tolls may finally begin falling.